Cephalalgia最新文献

{"title":"Effect of sumatriptan on ATP-sensitive potassium channel opening in migraine: A randomised controlled trial.","authors":"Zixuan Alice Zhuang, Mohammad Al-Mahdi Al-Karagholi, Håkan Ashina, Thien Phu Do, Messoud Ashina","doi":"10.1177/03331024251341464","DOIUrl":"10.1177/03331024251341464","url":null,"abstract":"<p><p>ObjectiveTo investigate whether early administration of sumatriptan prevents migraine induced by ATP-sensitive potassium (K_ATP) channel opener levcromakalim.MethodsThis single-centre, randomised, double-blind, placebo-controlled, two-way crossover study included adults with migraine without aura. Participants received a 20-minute intravenous infusion of levcromakalim on two separate occasions, followed immediately by a 10-minute intravenous infusion of either sumatriptan or placebo (isotonic saline) in a balanced allocation. The primary endpoint was the difference in the incidence of levcromakalim-induced migraine aftersumatriptan versus placebo over 12 hours. A secondary endpoint was the area under the curve (AUC) for headache intensity scores between experimental days.ResultsTwenty of 24 participants completed the study. The incidence of migraine induced by levcromakalim was 75% following sumatriptan and 85% following placebo (<i>p</i> = 0.69). The AUC for headache intensity scores showed no difference between sumatriptan and placebo days (<i>p</i> = 0.12). Post-hoc analyses correcting for intensity at 40 minutes post-levcromakalim revealed a significantly lower AUC for headache intensity following sumatriptan compared with placebo (<i>p</i> = 0.002).ConclusionsEarly sumatriptan treatment does not prevent migraine induced by K_ATP channel opening, suggesting that K_ATP-induced migraine occurs downstream of sumatriptan's site of action. However, sumatriptan reduces headache intensity, warranting further exploration of its modulatory effects.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251341464"},"PeriodicalIF":5.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensitizing effect of antimigraine drug sumatriptan on capsaicin-sensitive lung vagal neurons via 5-HT_1B/1D receptors and PKA: Relevance to adverse chest effects.","authors":"Nai-Ju Chan, Yueh-Yin Chen, Chun-Chun Hsu, You Shuei Lin","doi":"10.1177/03331024251355949","DOIUrl":"https://doi.org/10.1177/03331024251355949","url":null,"abstract":"<p><p>BackgroundThe antimigraine drug sumatriptan causes adverse chest effects, namely dyspnea and chest tightness, through unclear mechanisms. Dyspnea is an unpleasant sensation evoked by peripheral sensory signals transmitted to the central nervous system. Capsaicin-sensitive lung vagal (CSLV) afferents are nociceptive-like fibers that provide sensory input from the airways and lungs, mediating airway defense reflexes and evoking unpleasant respiratory sensations. The present study was carried out to investigate the role of CSLV afferents in mediating these adverse chest effects.MethodsExperiments were performed using male Brown-Norway rats. In an <i>in vivo</i> study, we investigated the effect of sumatriptan on CSLV-fiber activities and fiber-mediated airway reflexes using single fiber recordings and breathing pattern monitoring in anesthetized rats. In an <i>in vitro</i> study, the effect of sumatriptan on neuronal sensitivity was evaluated using Ca²⁺ imaging in rat primary cultured CSLV neurons.ResultsOur results showed that intravenous infusion of sumatriptan increased the excitability of CSLV afferents to chemical and mechanical stimuli in anesthetized rats; this sensitizing effect occurred 3-20 minutes after termination of the sumatriptan infusion and reversed by 80 minutes later. In isolated CSLV neurons, sumatriptan-induced enhancement of Ca²⁺ transients evoked by capsaicin was blocked by pretreatment with a 5-hydroxytryptamine 1B and 1D (5-HT_1B/1D) receptor antagonist and a protein kinase A inhibitor, whereas an antagonist of the transient receptor potential ankyrin 1 failed to do so. Additionally, in anesthetized, spontaneously breathing rats, a sumatriptan infusion potentiated changes in CSLV afferent-mediated breathing patterns, suggesting that enhanced sensory signals were transmitted to the central nervous system. Similarly, this potentiating effect was also abolished by a 5-HT_1B/1D receptor antagonist. Furthermore, immunofluorescence staining confirmed that 5-HT_1B/1D receptors were expressed in isolated CSLV neurons.ConclusionsWe concluded that sumatriptan sensitizes CSLV afferents through a direct action on 5-HT_1B/1D receptors expressing in nerve endings followed by protein kinase A activation in rats. These findings suggest that sensitization of CSLV afferents may contribute to the chest discomfort experienced by some migraineurs following sumatriptan administration.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251355949"},"PeriodicalIF":5.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cranial autonomic symptoms as a protective mechanism in patients with chronic migraine: A cross-sectional study.","authors":"Maria Dolores Villar-Martinez, Peter J Goadsby","doi":"10.1177/03331024251359564","DOIUrl":"https://doi.org/10.1177/03331024251359564","url":null,"abstract":"<p><p>AimTo identify clinical predictors of cranial autonomic symptoms (CAS) in chronic migraine (CM) and explore the role of cranial parasympathetic outflow.MethodsWe conducted a cross-sectional study using audit data from first consultation letters of 333 patients diagnosed with CM at King's College Hospital London (January 2015 to September 2019). All met the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria for CM. Predictors included sex, aura, age, pain quality and headache laterality. A generalized linear regression model with a Poisson distribution was used to analyze CAS count predictors.ResultsOf 333 cases, 85.2% were female and 54% reported aura. CAS were present in 75.1%, with 19.8% experiencing unilateral symptoms. CAS count was positively skewed (mode = 0; median = 2). Female sex (<i>β</i> = 0.244; <i>p</i> = 0.036), aura (β = 0.328; <i>p</i> < 0.001) and unilateral CAS (<i>β</i> = 0.317; <i>p</i> < 0.001) were significant positive predictors. Pain quality and age were not significant.ConclusionsFemale sex and aura are linked to increased CAS in CM. Enhanced trigeminal-autonomic reflex activation may represent a protective cerebrovascular mechanism. CAS may contribute to maintaining perfusion or modifying nociceptive input during attacks. Targeted therapies modulating this pathway could benefit females with aura and frequent CAS.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251359564"},"PeriodicalIF":5.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of visual snow syndrome in Japan and its association with migraine.","authors":"Yukihisa Suzuki, Motohiro Kiyosawa","doi":"10.1177/03331024251360337","DOIUrl":"https://doi.org/10.1177/03331024251360337","url":null,"abstract":"<p><p>ObjectiveVisual snow syndrome (VSS) is closely linked to migraine and involves variable visual disturbances. The present study aimed to investigate the associations between VSS and migraine, as well as VSS and anisometropia.MethodsWe studied 148 patients with VSS (54 males and 94 females, mean age 30.0 years) and 157 control participants. The mean and difference between left and right spherical equivalent refractive values, as well as the presence of migraines, were compared in patients with VSS and healthy controls. Multivariable logistic regression analyses were performed to assess the association between migraine and symptoms (palinopsia, entoptic phenomena, nyctalopia, photophobia, hyperesthesia and tinnitus) in patients with VSS.ResultsPatients with VSS exhibited a greater difference in left and right spherical equivalent refractive values and a higher prevalence of migraine compared to controls. Logistic regression analyses revealed a significant association between migraines and palinopsia. During the follow-up period, we observed spontaneous improvement in symptoms in 10 patients.ConclusionVSS is closely associated with migraine, and anisometropia was more frequent in VSS. The high prevalence of VSS in young individuals may reflect the age-related decline in migraine prevalence.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251360337"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grey-matter network topology in migraine with aura.","authors":"David M Niddam, Kuan-Lin Lai, Yi-Ting Hsiao, Yen-Feng Wang, Shuu-Jiun Wang","doi":"10.1177/03331024251353146","DOIUrl":"https://doi.org/10.1177/03331024251353146","url":null,"abstract":"<p><p>BackgroundInter-regional covariation in grey-matter (GM) structure may provide insights into disease mechanisms. Given that migraine with aura (MA) has been linked to occipital GM alterations, it is plausible that altered occipital GM covariance may also exist in MA.MethodsStructural magnetic resonance images were obtained from 50 MA patients, 50 migraine patients without aura (MO) and 50 healthy controls (HC). Mean GM densities were extracted according to the Automated Anatomical Labeling atlas and regional and global network metrics were compared among the three groups. The local measures primarily focused on occipital regions. We further examined whether voxel-wise covariance of the significant regions was associated with clinical parameters.ResultsIncreased nodal degree was observed in the right lingual gyrus in MA when compared with HC (p < 0.001, p(_FDR) = 0.018) and MO (p = 0.005, p(_FDR) = 0.059), though the latter did not pass correction. In MA, the right lingual gyrus was identified as a hub region and its covariance with the right posterior insula and the left ventral postcentral gyrus was negatively correlated with migraine duration. Global network measures did not differ among the groups.ConclusionMA was associated with localized changes in the GM-network of the visual system, which may interact with pain-related brain regions depending on the duration of the disorder.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251353146"},"PeriodicalIF":5.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-stress modulation of the HPA and melanocortin systems alleviates migraine-like behaviors in mice.","authors":"Ya-Yu Hu, Hao-Ruei Mei, Shruti Sankar, Abbas Pirwani, Armen Akopian, Christa McIntyre, Gregory Dussor","doi":"10.1177/03331024251352856","DOIUrl":"https://doi.org/10.1177/03331024251352856","url":null,"abstract":"<p><p>BackgroundStress is a major trigger for migraine attacks. Stress activates the hypothalamic-pituitary-adrenal (HPA) axis, releasing glucocorticoids (GCs) to maintain homeostasis, and migraine attacks may occur as an adverse effect of this response. We previously demonstrated in a mouse model that inhibiting corticosterone (CORT) synthesis by administering metyrapone before stress prevented stress-induced migraine-like behaviors. Given the unpredictable nature of stressors and their onset or termination, it is critical to better understand the adaptive and maladaptive effects of the HPA stress response. Here, we aimed to evaluate the effects of HPA axis modulation following the end of stress exposure.MethodsRepeated stress induces migraine-like behaviors and priming to sodium nitroprusside (SNP) in mice. Metyrapone (to inhibit CORT synthesis), CORT (to evaluate its effects after exogenous administration), and adrenocorticotropic hormone (ACTH) (to test the effects of a hormone upstream to CORT) were administered post-stress. Additionally, α-melanocyte-stimulating hormone (α-MSH, an ACTH cleavage product) and tetrahydroisoquinoline (THIQ), a melanocortin 4 receptor (MC4R) agonist, were administered to examine melanocortin receptor involvement. Facial hypersensitivity was assessed via von Frey testing and grimace scoring was used to evaluate non-evoked pain. Serum CORT levels were measured in both control and stressed mice following ACTH administration.ResultsWe examined post-stress HPA axis modulation on stress-induced facial hypersensitivity. Metyrapone reduced acute-phase hypersensitivity and reduced priming to SNP, suggesting sustained synthesis of CORT after stress plays a role in development of migraine-like behavior. Surprisingly, both CORT and ACTH treatments at 1- and 24-h post-stress alleviated stress-induced behaviors and priming. To determine if ACTH effects were mediated by an elevation in circulating CORT, metyrapone was administered before the ACTH injection. Metyrapone increased the ACTH reversal of stress effects on facial hypersensitivity. Furthermore, post-stress ACTH injections significantly increased serum CORT levels within 30 min. In addition to ACTH effects on CORT levels, ACTH effects could be mediated by the melanocortin system. Post-stress administration of α-MSH or the MC4R agonist THIQ, reduced migraine-like behaviors.ConclusionsThere is a complex relationship between stress, the HPA axis, and melanocortin signaling, in the effects of repeated stress exposure on migraine-like behaviors. In the early post-stress response phase, there are contributions from both CORT and MC4R signaling in the maintenance of behavioral effects. These findings suggest that targeting the HPA axis and MC4R after stress may be a potential therapeutic approach for stress-induced migraine attacks.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251352856"},"PeriodicalIF":5.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ongoing pursuit of migraine triggering mechanisms.","authors":"Anna P Andreou, Luigi Francesco Iannone","doi":"10.1177/03331024251342583","DOIUrl":"https://doi.org/10.1177/03331024251342583","url":null,"abstract":"","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251342583"},"PeriodicalIF":5.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genome sequencing reveals the <i>Adgrl3</i> (<i>ADGRL3</i>) gene as a possible cause of cephalic hypersensitivity in the STA rat and migraine in humans.","authors":"Brian Skriver Nielsen, Hongru Wang, Tanya Ramdal Techlo, Lisette Kogelman, Sarah Louise Christensen, Sanne Hage la Cour, Sabrina Prehn Lauritzen, Gordon Munro, Steffen Petersen, Marlene Danner Dalgaard, Morten Erik Allentoft, Thomas Folkmann Hansen, Rasmus Nielsen, Jes Olesen, Inger Jansen-Olesen, David Møbjerg Kristensen","doi":"10.1177/03331024251352844","DOIUrl":"https://doi.org/10.1177/03331024251352844","url":null,"abstract":"<p><p>BackgroundMigraine is a common primary headache disorder with a significant genetic component influencing its pathophysiology, in which the trigeminal system plays a central role. The spontaneous trigeminal allodynia (STA) inbred rat strain is a validated migraine model that exhibits a chronic cephalic hypersensitive phenotype, responsive to specific migraine treatments. The heritable STA trait presents a unique opportunity to dissect the genetic component of migraine.MethodsSTA rats were backcrossed twice with wild-type (WT) Sprague-Dawley (SD) rats and whole-genome sequencing was performed on 47 rats exhibiting either the STA or WT phenotype. mRNA and protein expression analyses were conducted in the trigeminovascular system of both rats and humans. Based on data from the STA rats, we performed an F-SKAT (i.e. sequence kernel association test for family data) analysis to investigate a potential link between families with clustering of migraine and our findings from the STA rats.ResultsSequencing of STA rats revealed a risk locus near the gene for adhesion G protein-coupled receptor L3 (<i>Adgrl3</i>). In humans, the <i>ADGRL3</i> gene showed an increased burden of rare variants segregating with migraine in families with a clustering of the condition (<i>p</i> = 0.046). We found similar associations between migraine and the <i>ADGRL3</i> when expanding the analyses to a genome-wide analysis including rare variants from more than one million individuals with migraine. Expression analyses of rat and human tissues confirmed that Adgrl3 is expressed in the migraine-associated trigeminovascular system.ConclusionsIn this translational study, <i>ADGRL3</i> was associated with both cephalic hypersensitivity in STA rats and an increased burden of rare variants in humans with migraine. The gene was expressed in the trigeminovascular system, a central pathophysiological component of cephalic pain. <i>ADGRL3</i> provides novel insights into the pathophysiology of chronic cephalic pain in migraine.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251352844"},"PeriodicalIF":5.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic characterization of the endocannabinoid system and psychiatric features in patients with migraine and medication overuse headache.","authors":"Marina Romozzi, Lucia Scipioni, Sonia Di Tella, Maria Caterina Silveri, Letizia Maria Cupini, Catello Vollono, Mauro Maccarrone, Paolo Calabresi","doi":"10.1177/03331024251314460","DOIUrl":"https://doi.org/10.1177/03331024251314460","url":null,"abstract":"<p><p>BackgroundThe endocannabinoid system (ECS) is one of the key endogenous systems regulating pain. Preclinical and clinical evidence suggests a dysregulation of the ECS in patients with migraine. The present study aimed to characterize the main ECS components in patients with chronic migraine and medication overuse headache (MOH) and episodic migraine (EM) at the gene expression level compared to healthy controls (HC) and to correlate the findings with psychopathological scales.MethodsIn this cross-sectional study, consecutive patients with a diagnosis of EM and MOH were enrolled. Fatty acid amide hydrolase (FAAH) was assayed through quantitative enzyme-linked immunosorbent assay kits. The gene expression of ECS components (FAAH, <i>N</i>-arachidonoyl phosphatidylethanolamine-specific phospholipase D (NAPE-PLD) and <i>N</i>-acylethanolamine acid amidase (NAAA) enzymes, cannabinoid (CB) receptors, CB₁ and CB₂, transient receptor potential vanilloid type 1 (TRPV1) and peroxisome proliferator-activated receptor (PPAR)ɑ receptors was assayed in peripheral blood mononuclear cells through a real-time quantitative PCR. Clinical data including Migraine Disability Assessment (MIDAS) and Headache Impact Test-6 (HIT-6) were collected. Psychopathological status was assessed through the Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Rating Scale for Depression (HAM-D) and the Toronto Alexithymia Scale (TAS-20).ResultsThe study included 31 patients (15 with EM, 16 with MOH) and 14 HC. The gene expression of FAAH, an enzyme involved in the degradation of the main endocannabinoid, was significantly lower in MOH patients (0.0002 ± 0.0002) than in EM patients (0.0008 ± 0.0006) (<i>p</i> = 0.005). There were no significant differences in gene expression among EM, MOH and HC groups for NAPE-PLD, NAAA, CB₁, CB₂, TRPV1 and PPARɑ. The levels of FAAH protein expression were significantly higher in MOH (2.9517 ± 2.2006 pg/μg) compared to EM patients (0.9225 ± 0.6878 pg/μg) (<i>p</i> = 0.025). In the clinical group (EM and MOH), we found a significant negative correlation between FAAH gene expression and FAAH enzyme protein (<i>p</i> = 0.014); FAAH gene expression negatively correlated with HIT-6 (<i>p</i> = 0.003) and MIDAS scores (<i>p</i> = 0.048), as well with all psychopathological scales, in more detail with TAS-20 (<i>p</i> = 0.029), HAM-A (<i>p</i> = 0.040) and HAM-D (<i>p</i> = 0.028).ConclusionsFAAH undergoes specific alterations in patients with MOH at gene expression levels, suggesting its potential as a blood biomarker for this condition. FAAH gene expression is possibly related to psychiatric comorbidities in migraine patients.</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251314460"},"PeriodicalIF":5.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interactive CBT for headache and relaxation training (iCHART): Single-arm pilot trial of cognitive behavioral therapy for veterans with post-traumatic headache.","authors":"Amy S Grinberg, Daniel G Rogers, Olivia Datre, Sarah Anthony, Sarah W Clark, Stanley C Takagishi, Elizabeth Seng, Brenda T Fenton, John P Ney, Jason J Sico","doi":"10.1177/03331024251351598","DOIUrl":"10.1177/03331024251351598","url":null,"abstract":"<p><p>BackgroundCognitive behavioral therapy for headache (CBT-HA) improves headache-related outcomes, but accessibility barriers limit its use. This pilot study evaluated the feasibility, acceptability and clinical signal of an interactive voice response (IVR)-delivered CBT-HA intervention for veterans with post-traumatic headache (PTH).MethodsA single-arm pilot trial was conducted with 18 veterans diagnosed with PTH. Participants completed a 10-week IVR-CBT-HA program. Outcomes were assessed at baseline, immediately post-treatment and one-month follow-up. Primary outcomes included changes in headache days, interference, disability, feasibility and acceptability.ResultsFifteen participants completed the study. Headache frequency, headache-related disability, depressive symptoms, anxious symptoms, sleep quality and headache catastrophizing were not statistically significant. Self-efficacy significantly improved from baseline to post-treatment (<i>F</i>_2,12 = 8.71, <i>p</i> = 0.001), and remained stable at follow-up. Participants reported high satisfaction with the intervention (27.73/32, SD = 5.66) but low system usability (mean = 20.83/100, SD = 15.72). Study therapists rated the intervention as highly acceptable (acceptability of intervention: mean = 4.83/5, SD = 0.37) and feasible (feasibility of intervention measure: mean = 4.92/5, SD = 0.28). Interactive CBT for headache and relaxation training (i.e. iCHART) resulted in an approximately 33% cost savings compared to traditional CBT-HA.ConclusionsAsynchronous, IVR-delivered CBT-HA was feasible, acceptable and cost-effective for veterans with PTH. Although headache reductions were not statistically significant, self-efficacy improvements suggest long-term benefits. Future research should explore technology refinements and larger randomized trials.Trial RegistrationClinicalTrials.gov: NCT05093556 (registered 26 October 2021).</p>","PeriodicalId":10075,"journal":{"name":"Cephalalgia","volume":"45 7","pages":"3331024251351598"},"PeriodicalIF":4.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}